The Pennsylvania Coalition Against Domestic Violence says the state ranks fourth in the nation for murder-suicides.

The group said Monday domestic abuse happens every day and it often goes unreported until it is too late. Last year, 95 people were killed.

An advocate from the Women's Help Center in Johnstown said abuse starts because of issues of control. The center said coming forward and admitting you have a problem is the hardest part for the victims. Advocates said it is important that family and friends look for the signs.